Mental health for all: fostering healthy lifestyles
Authors: Danuta Wasserman
Journal: World Psychiatry (2023)

The burden of mental health is high, affecting people from all walks of life1. Good mental health is an essential aspect of overall well-being and significantly impacts an individual's daily and lifelong quality of life. Despite this, there is often a lack of actions taken to address the growing mental health problems2. The issue of the global mental health situation is especially critical due to the harsh consequences of the COVID-19 pandemic, wars, natural catastrophes, and climate change, causing human suffering, economic challenges, and downturns3. Psychological and pharmacological treatments for mental health conditions are not delivered at a pace that meets the growing demand for mental health services. Policy and decision-makers should facilitate provision of resources both to the health care system and to the communities, which need to work hand in hand to achieve best results in treatment, rehabilitation, and early prevention. But pharmacotherapy and psychotherapy are not the only means to treat and rehabilitate. In addition, there is an important but often forgotten component aiming to involve individuals with mental health problems to take an active role in the recovery of their own health. The idea that "one's everyday life is in one's hands" can positively affect mental health by promoting a sense of agency and empowerment. This belief can help individuals feel more in control of their life, reducing feelings of helplessness, anxiety and stress. The awareness of factors such as positive social relationships, active engagement in healthy lifestyle behaviours, and exposure to nature as facilitators of positive mental health and well-being needs to be revived and boosted4. During my forthcoming mandate as WPA President, I will focus on increasing awareness of the role of healthy lifestyles in preservation and promotion of good mental and somatic health5, 6. In this context, it is important to keep in mind that professionals also need to take care of their own mental and somatic health. Pedagogically tailored examples of lifestyle activities added to the existing biological and psychological therapies, when used daily in psychiatric care, can increase feelings of governing one's life and give an additional dimension to the meaning of life7. The literature supports that physical activity can improve mental health in individuals who have a sedentary lifestyle. Video materials for patients and health care staff about physical activity and examples on how to easily perform physical exercises in the everyday life on psychiatric or somatic wards are being developed with the collaboration of the WPA Planning Committee and colleagues from Karolinska Institute, Stockholm, Sweden. Physical activity conducted together with psychiatric staff can increase connectivity between patients and professionals through shared experience, improved communication, increased empathy, decreased levels of hierarchy, and personalized attention as well as improved physical condition and health of the participating personnel. Similar materials are in preparation on healthy nutrition8 for psychiatric patients by the WPA Planning Committee and colleagues from the University of Campania "Luigi Vanvitelli" based on a nationwide Italian study9. In this study, a psychoeducational group intervention focused on healthy lifestyle significantly improved the likelihood of people with severe mental disorders to follow a healthy and balanced nutritional regimen, with positive effects on metabolic indices. Other healthy lifestyles which I aim to focus on are sleep hygiene10, workplace satisfaction11, and use of active leisure time and hobbies12. Psychiatrists could take an active role in increasing decision makers' knowledge on how housing, habitats, public spaces and work environments influence mental health. Awareness of the influence on mental health of environment, such as green spaces with plants and art in the wards, should also be increased in everyday clinical practice and incorporated into patients' activities13. In the preparation of video and other educational materials for the above-mentioned purposes, the vast knowledge and resources of members of the respective WPA Scientific Sections will be utilized. Fostering lifestyles is relevant for patients with both mental and somatic illnesses treated in all types of health care facilities and public health settings. Last but not least, promoting educational activities on how to cope with the consequences of wars and natural disasters, which have a tremendous influence on the somatic and mental health of entire populations, will be my priority. Healthy lifestyles are critical to cognitive, emotional and behavioural changes and can have a strong impact on one's self-image. Promoting healthy lifestyles as a public mental health strategy has the potential to alleviate the mental health burden in society, thus hopefully decreasing the cost of health care services. However, they must be adopted based on the culture and context, also taking into account the acceleration of immigration and globalization. By encouraging healthy lifestyles, the WPA community can create a supportive environment that promotes positive mental health and well-being for all. Thus, it will be possible for the WPA to contribute to the United Nations' Sustainable Development Goals, especially to Goal 3 ("Ensure healthy lives and promote well-being for all at all ages"), and reduce premature mortality due to suicide, which is the utmost consequence of poor mental health14, 15.